Category: Nevin Manimala

Int J Paediatr Dent. 2023 Jan 20. doi: 10.1111/ipd.13048. Online ahead of print.

ABSTRACT

BACKGROUND: Limited evidence regarding the post-COVID dental status of paediatric patients is available, with most studies assessing only children’s oral health habits.

AIM: To evaluate the effect of COVID-19 lockdown on the oral health of paediatric dental patients in Greece.

DESIGN: This was a retrospective cohort study that included a questionnaire reporting on children’s oral health behavior and a clinical examination assessing dental caries and dental treatment needs using the ICDAS criteria, dmft/DMFT, and Treatment Need Index. Wilcoxon sign ranked test was used for statistical comparison of questionnaire and clinical data before, during and after the lockdown.

RESULTS: A total of 102 children with a median age of 9 years-old were recruited from current patients attending the clinic that had their last dental exam 6 months prior to the lockdown. Results from the questionnaire showed decreased brushing frequency, increased eating frequency and sugar consumption during the lockdown period (p< 0.001). Moreover, 16.5% had to visit the dentist for urgent care during the lockdown, 13.6% experienced dental pain, while 51.5% did not experience any dental emergencies. Clinical examination, after the lockdown, recorded significant increased mean dmft/DMFT scores by 0.63 units in the primary dentition (p=0.01) and 0.52 units in the permanent (p=0.002). Significantly higher treatment needs, with more carious lesions requiring extensive treatment after the lockdown were recorded (p<0.001).

CONCLUSIONS: Covid-19 lockdown negatively affected children’s oral health behavior; caries prevalence increased while more complex dental treatments were required after the lockdown.

PMID:36680387 | DOI:10.1111/ipd.13048

Oral Dis. 2023 Jan 20. doi: 10.1111/odi.14514. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the association of SYN2, PPARG, RAF1, TIMP4 and IQSEC1 polymorphisms in 3p25 with oral squamous cell carcinoma (OSCC) in the Chinese Han population.

SUBJECTS AND METHODS: Genomic DNA was extracted from 494 subjects with or without OSCC. Basic information on the subjects, clinical data, and prognoses were collected. Fifteen candidate single nucleotide polymorphisms (SNPs) were selected and genotyped. The statistical analyses included descriptive statistics, logistic regression, survival, and functional annotation was performed.

RESULTS: IQSEC1-rs2686742 correlated with OSCC occurrence. In addition, RAF1-rs1051208, PPARG-rs10865710, PPARG-rs3856806, IQSEC1-rs2686742, PPARG-rs1175544, IQSEC1-rs9211, and IQSEC1-rs2600322 were significantly associated with the clinical characteristics of patients with OSCC. The log-rank test showed that IQSEC1-rs2600322 may play an important role in the survival of patients with OSCC. The Cox regression analysis suggested that PPARG-rs10865710, PPARG-rs7649970, IQSEC1-rs9211, IQSEC1-rs2600322, and IQSEC1-rs12487715 influenced survival outcomes. The functional annotation indicated that the transcript levels of IQSEC1 were upregulated in head and neck squamous cell carcinoma tissues, whereas PPARG gene transcription was downregulated.

CONCLUSIONS: IQSEC1-rs2686742 may be closely associated with OSCC onset. Multiple SNPs in IQSEC1 and PPARG genes correlated with the clinical characteristics of OSCC, among which PPARG-rs10865710, IQSEC1-rs9211, and IQSEC1-rs2600322 were associated with cancer prognosis.

PMID:36680374 | DOI:10.1111/odi.14514

J Investig Med. 2023 Jan 20:10815589221149186. doi: 10.1177/10815589221149186. Online ahead of print.

ABSTRACT

Hypochloremia has recently gained interest as a potential marker of outcomes in patients with heart failure (HF). The exact pathophysiologic mechanism linking hypochloremia to HF is unclear but is thought to be mediated by chloride-sensitive proteins and channels located in kidneys. This analysis aimed to understand whether renal dysfunction (RD) affects the association of hypochloremia with mortality in patients with HF. Using data from a nationwide registry, 438 cases with complete data on serum chloride concentration and 1-year survival were included in the analysis. Patients with an estimated glomerular filtration rate of <60 mL/min/m² at baseline were accepted as having RD. Hypochloremia was defined as a chloride concentration <96 mEq/L at baseline. For HF patients without RD at baseline, patients with hypochloremia had a significantly higher 1-year all-cause mortality than those without hypochloremia (41.6% vs 13.0%, log-rank p < 0.001) and the association remained significant after multivariate adjustment (odds ratio (OR): 2.55, 95% confidence interval (CI): 1.25-5.21). The evidence supporting the association was very strong in this subgroup (Bayesian Factor (BF)₁₀: 48.25, log OR: 1.56, 95% CI: 0.69-2.43). For patients with RD at baseline, there was no statistically significant difference for 1-year mortality for patients with or without hypochloremia (36.3% vs 29.7, log-rank p = 0.35) and there was no evidence to support an association between hypochloremia and mortality (BF₁₀: 1.18, log OR :0.66, 95% CI: -0.02 to 1.35). In patients with HF, the association between low chloride concentration and mortality is limited to those without RD at baseline.

PMID:36680353 | DOI:10.1177/10815589221149186

Integr Cancer Ther. 2023 Jan-Dec;22:15347354221148710. doi: 10.1177/15347354221148710.

ABSTRACT

BACKGROUND: We explored the use of a novel smart phone-based application (APP) for delivery and monitoring of meditation to treat mood symptoms experienced by cancer patients.

METHODS: We assessed the feasibility of using a meditation delivery and tracking APP over 2-weeks and its impact on cancer patients’ self-reported anxiety and depression. Outpatients reporting depression and/or anxiety were recruited and randomized to the APP or waitlist control group. Assessments included an expectancy scale, exit survey, mood rating before and after each meditation, and the Edmonton Symptom Assessment Scale (ESAS-FS), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) at baseline and after 2-weeks. The primary aim was to assess feasibility; secondary aims included satisfaction with the APP, association between meditation frequency and length with self-reported symptoms, and change in symptom measures (symptoms, anxiety, depression, and sleep).

RESULTS: Our study included 35 participants (17 meditation group; 18 controls) who were primarily female (94%) with breast cancer (60%). The 61% enrollment rate and 71% adherence rate met pre-specified feasibility criteria. Most meditation group participants described the APP as “Useful” to “Very Useful” and would “Probably” or “Definitely” recommend its use. Mixed model analysis revealed a statistically significant association between meditation length (5, 10, or 15 minutes) and change in anxiety, with 15-minute sessions associated with greater reductions in anxiety. In the exit survey, more meditation group vs. control group participants reported improved focus, mood, and sleep. Study groups differed significantly by ESAS fatigue score change; the meditation group decreased a median of 1.5 pts (IQR 2.5) and the control group increased a median of 0.5 points (IQR 2). The meditation group, but not the control group, experienced statistically significant improvement in ESAS fatigue, depression, anxiety, appetite, and physical, psychological, and global distress. Change in PSQI and HADS anxiety and depression scores did not reveal any statistically significant between-group differences.

CONCLUSIONS: This pilot study demonstrated the feasibility and acceptability of a meditation APP for cancer patients. Meditation APP users reported improvement in several measures of symptom distress. Future studies should explore ways to enhance the APP’s usability and clinical benefit.

PMID:36680352 | DOI:10.1177/15347354221148710

J Public Health Dent. 2023 Jan 20. doi: 10.1111/jphd.12555. Online ahead of print.

ABSTRACT

OBJECTIVES: The Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated $100 billion to the Provider Relief Fund, allowing for direct payments to health care providers due to COVID-19. Few studies have evaluated participation in the Provider Relief Fund (PRF), and none have specifically looked at dental providers in the safety net.

METHODS: We conducted a retrospective, secondary data analysis using a quasi-experimental cohort design of South Carolina dentists who received PRF payments, comparing those who did and did not participate in the safety net. Safety net practice was operationalized as those participating in Medicaid, and whether they provided care in dental health professional shortage areas, or rural communities.

RESULTS: Of the 628 dental providers in South Carolina who received PRF payments, 34% were identified as Medicaid providers while 66% did not participate in Medicaid; we found no statistical difference between payments to Medicaid versus non-Medicaid dental providers. Of PRF payments to dental providers participating in South Carolina’s Medicaid program, we found no difference between payments to rural and urban providers but did find that practices offering services in dental care shortage areas received less than providers practicing in counties not designated as a shortage area.

CONCLUSIONS: The PRF achieved its goal of distributing financial support to providers affected by the COVID-19 pandemic. But without policy imperatives linked to need-based allocations or incentives for PRF recipients to serve safety net populations, we may later learn this was a missed opportunity for PRF.

PMID:36680347 | DOI:10.1111/jphd.12555

J Appl Lab Med. 2023 Jan 21:jfac129. doi: 10.1093/jalm/jfac129. Online ahead of print.

ABSTRACT

BACKGROUND: Phlebotomy can be an uncomfortable and even painful experience that increases in likelihood in patients who require frequent blood draws, such as those with cancer. The 25-gauge BD Vacutainer® UltraTouch™ Push Button Blood Collection Set has a smaller outer bore needle size and unique bevel configuration, which in theory should reduce pain associated with phlebotomy. Smaller needles typically cause less pain, however, they have a higher incidence of compromising the specimen integrity. Innovative engineering allows this particular needle to maintain a larger inner bore size similar to a standard 23-gauge needle. This study compares pain and specimen integrity between this novel device and a standard 23-gauge needle.

METHODS: Two cohorts of 190 patients each had phlebotomy performed with either needle. Pain experienced was assessed by patient surveys, rating pain from 0 (low) to 10 (high). Sample integrity was assessed by determining the hemolysis index (Abbott Architect c8000).

RESULTS: No statistically significant difference in median pain scores was observed between the 2 cohorts, P-value: 0.068. The 23-gauge cohort more frequently reported 3+ pain than the 25-gauge cohort, 14/190 vs 5/190. Pain scoring 1 and 2 was more frequent in the 25-gauge cohort, 84/190 vs 54/190. Pain scores of 0 were more frequent in the 23-gauge cohort, 122/190 vs 101/190. This stratification is statistically significant, P-value: 0.003. The 25-gauge needle showed no increase in hemolysis rates, P-value: 0.5.

CONCLUSIONS: Sample integrity was identical between both needles. The 25-gauge needle resulted in less 3+ pain, while pain scoring 1 and 2 was more frequent in the 25-gauge cohort.

PMID:36680315 | DOI:10.1093/jalm/jfac129

BJU Int. 2023 Jan 20. doi: 10.1111/bju.15970. Online ahead of print.

ABSTRACT

OBJECTIVE: We report NHS England data for patients with bladder cancer (BC), upper tract urothelial (UTUC: renal pelvic and ureteric) and urethral cancers from 2013 to 2019.

MATERIALS AND METHODS: Hospital episode statistics, waiting times and cancer registrations were extracted from NHS Digital.

RESULTS: Registrations included 128,823 individuals with BC, 16,018 with UTUC and 2,533 with urethral cancer. In 2019, 150,816 persons were living with a diagnosis of BC, of whom 113,067 (75.0%) were men, 85,117 (56.5%) aged over 75 yrs, and 95,553 (91.7%) Caucasian. Incidence rates were stable (32.7-34.3 for BC, 3.9-4.2 for UTUC and 0.6-0.7 for urethral cancer per 100,000 population). Most patients (52,097 (41.3% (40.7-42.0%)) were referred outside the two week wait pathway and 15,340 (12.2% (11.7-12.6%)) presented as emergencies. Surgery, radiotherapy, chemotherapy or multimodal treatment use varied with disease stage, patient factors and Cancer Alliance. Between 27-29% (6,616) of muscle-invasive BCs did not receive radical treatment. Survival rates reflected stage, grade, location and tumour histology. Overall survival rates did not improve over time (relative change: 0.97 (95%CI: 0.97-0.97) at 2 years) in contrast to other cancers.

CONCLUSION: The diagnostic pathway for BC needs improvement. Increases in survival might be delivered through greater use in radical treatment. NHS Digital data offers a population-wide picture of this disease but does not allow individual outcomes to be matched with disease or patient features and key parameters can be missing or incomplete.

PMID:36680312 | DOI:10.1111/bju.15970

Viruses. 2023 Jan 10;15(1):201. doi: 10.3390/v15010201.

ABSTRACT

BACKGROUND: Chile has achieved the highest coverage for vaccines against the SARS-CoV-2 virus worldwide.

OBJECTIVE: To assess the progression of immunity (natural and acquired by vaccine) in a cohort from two Chilean cities.

METHODS: Individuals (n = 386) who participated in three phases of population-based serial prevalence studies were included (2020-2021 and 2022). Presence of SARS-CoV-2 antibodies was measured in serum. Data including time of vaccination and type of vaccine received were analysed with descriptive statistics.

RESULTS: Seroprevalence was 3.6% in the first round and increased to 96.9% in the second and 98.7% in the third. In the third round, 75% of individuals who had received the basal full scheme were seropositive at 180 days or more since their last dose; 98% of individuals who received one booster dose were seropositive at 180 days or more, and 100% participants who received two boosters were seropositive, regardless of time since their last dose. Participants receiving mRNA vaccines had higher seroprevalence rates over time.

CONCLUSIONS: The high vaccination coverage in Chile enabled the population to maintain high levels of antibodies. Vaccination boosters are essential to maintain immunity over time, which also depends on the type of vaccine administered.

PMID:36680241 | DOI:10.3390/v15010201

Viruses. 2023 Jan 5;15(1):166. doi: 10.3390/v15010166.

ABSTRACT

Norovirus is the leading viral agent of gastroenteritis in humans. RNA-dependent RNA polymerase (RdRp) is essential in the replication of norovirus RNA. Here, we present a comprehensive evolutionary analysis of the norovirus GI RdRp gene. Our results show that the norovirus GI RdRp gene can be divided into three groups, and that the most recent common ancestor was 1484. The overall evolutionary rate of GI RdRp is 1.821 × 10^-3 substitutions/site/year. Most of the amino acids of the GI RdRp gene were under negative selection, and only a few positively selected sites were recognized. Amino acid substitutions in the GI RdRp gene accumulated slowly over time. GI.P1, GI.P3 and GI.P6 owned the higher evolutionary rates. GI.P11 and GI.P13 had the faster accumulation rate of amino acid substitutions. GI.P2, GI.P3, GI.P4, GI.P6 and GI.P13 presented a strong linear evolution. These results reveal that the norovirus GI RdRp gene evolves conservatively, and that the molecular evolutionary characteristics of each P-genotype are diverse. Sequencing in RdRp and VP1 of norovirus should be advocated in the surveillance system to explore the effect of RdRp on norovirus activity.

PMID:36680206 | DOI:10.3390/v15010166

Viruses. 2023 Jan 5;15(1):162. doi: 10.3390/v15010162.

ABSTRACT

Wastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown to be an important approach to determine early outbreaks of infections. Wastewater-based epidemiology (WBE) is regarded as a complementary tool for monitoring SARS-CoV-2 trends in communities. In this study, the changes in the SARS-CoV-2 RNA levels in wastewater during Easter holidays in 2021 and 2022 in the City of Cape Town were monitored over nine weeks. Our findings showed a statistically significant difference in the SARS-CoV-2 RNA viral load between the study weeks over the Easter period in 2021 and 2022, except for study week 1 and 4. During the Easter week, 52% of the wastewater treatment plants moved from the lower (low viral RNA) category in 2021 to the higher (medium to very high viral RNA) categories in 2022. As a result, the median SARS-CoV-2 viral loads where higher during the Easter week in 2022 than Easter week in 2021 (p = 0.0052). Mixed-effects model showed an association between the SARS-CoV-2 RNA viral loads and Easter week over the Easter period in 2021 only (p &lt; 0.01). The study highlights the potential of WBE to track outbreaks during the holiday period.

PMID:36680203 | DOI:10.3390/v15010162